Colombia kicks off 1st clean needle program for drug addicts

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Health professionals began distributing clean needles to heroin addicts in five Colombian cities on Wednesday, after the launch of a new program to reduce the spread of HIV and Hepatitis, local media reports.

The nationwide program began on the streets of Medellin, Bogota, Cali, Cucuta, and Armenia Wednesday, as Ministry of Health employees searched for hangouts popular to heroin users, according to Colombia’s El Tiempo newspaper.

The Ministry of Health has so far allotted 100,000 clean syringe kits for distribution among addicts, while used needles will be collected and destroyed by trained personnel.

According to a North American Congress on Latin America report, a 2010 study showed that 3.8% among a sample of 231 heroin addicts in Medellin were HIV-positive, while a 2011 study of 141 heroin users in Cucuta and Pamplona showed a 9% rate of HIV infection. Most recently, Bogota’s health secretary reported a 23% increase of HIV cases in 2013; of the total number of people know to be infected, 325 died of the illness.

While the director of the Center for Drug and Safety Studies at the University of the Andes says the program is aimed at only controlling the spread of AIDS and Hepatitis B and C and not about reducing drug consumption, the Ministry of Health hopes that the delivery of kits will bring some addicts into the health system with access to treatment.

According to the ministry’s Director of Mental Health, Aldemar Parra, the needle exchange is part of the “Response to Heroine Use” project within a national plan to reduce substance abuse.

Sources in the government said that the needle exchange program does not mean that they will distribute drugs of any kind, according to El Tiempo.

The Colombian government continues to take a strong position against the use of substitutes such as methadone or suboxone as means of treatment, arguing that “there is no scientific evidence in the world to show that a person can overcome an addiction with drug substitution.”

Recently, Bogota Mayor Gustavo Petro announced plans to open 20 new mobile medical care centers for drug addicts in Bogota, a program he began in 2012. The controversial care centers, or CAMADS, initially supplied drugs under strict medical prescriptions, and provided psychiatric, medical, and dental care to addicts.

Petro ran for mayor of Bogota in 2011 on a platform of progressive drug policies, in the midst of a polarized national debate on how to address drug consumption. While Colombia continued to draw income from the so-called “war on drugs,” to the tune of $5.7 billion from the US alone between 2000 and 2010, many argued that the criminalization of drugs played directly into the hands of drug cartels and armed groups, who used the illegal trade to gain economic and political power.

A 2013 OAS summit on the problem of drug consumption, as well as a 2014 meeting and report by the Research Consortium on Drugs and the Law (CEDD) suggest that Colombia may be headed for policy change as national analysts agree that the “war on drugs” has failed, and that punitive policies have not worked.

The CEDD report concluded that the criminalization of drug consumption “harms drug users, and does not reduce consumption;” that it prohibits their ability to be considered impartially by police and the judicial system; prevents addicts from seeking help; and that money spent on the penalization of drug use would be better spent in the health sector to prevent and treat addiction.

Prohibition

Colombia’s 1991 constitution, which expanded and defined individual freedoms, allowed for small amounts of drugs for personal consumption. In 1994, the constitutional court ruled that possession or use of a “personal dose” could not be penalized, and in 2008 the supreme court increased the legal amount for a personal dose.

Under the administration of Alvaro Uribe, the 2009 congress approved the prohibition of drug use, restricting the scope of constitutional freedom. Although the legislation was never upheld in the Supreme Court and has never been regulated, in practice any amount of drug use or possession was deemed illegal. Furthermore, a penal law was passed in 2011 stating that possession of the smallest amount of drugs was punishable by a minimum sentence of 5.3 years of prison.

In 2012, the constitutional court approved a government proposal to decriminalize small amounts of cocaine and marijuana. Currently, while all drugs are still deemed illegal, anyone caught with fewer than 22 grams of marijuana or one gram of cocaine for personal use may not be prosecuted or detained.

However, recent interviews with the National Police conducted by CEDD show that weekly quotas imposed on officers have resulted in drug seizures even when drug possession does not exceed legal amounts. Police are also allowed to detain anyone who is in “an excited state,” in order to prevent future crimes, whether or not the amount in possession exceeds the legal dose. According to testimonies of consumers, the treatment they receive during confrontation and detention is “violent and denigrating,” and in most cases, police demand money.

Drug use as health problem

In 2004, Colombia created the first National Commission for Drug Demand Reduction. By the time the National Policy to Reduce the Use and Impact of Psychoactive Substances was passed in 2007, the conversation had changed from drug prevention to risk and harm reduction, and the building of a public system with the capacity to address addiction.

In 2011, the Constitutional Court ruled that healthcare providers in the public and private sectors must offer medical treatment to drug users, effectively ruling that addiction is an illness rather than a crime.

Access to treatment is still very limited in Colombia: in 2013, only 25 out of 32 Colombian states offered treatment services, according to the national healthcare registry. Most facilities are concentrated in cities, and 84% of them are private. Additionally, according to CEDD, the vast majority of drug treatment centers in Colombia are operating illegally, with no government oversight.

Punitive drug policies in Colombia “a complete failure”

Last week, two months after his reinstatement as mayor of the nation’s capital, Petro announced plans to open 20 more mobile centers, which he claims have helped over 12,000 drug users in Bogota.

However, the mayor says that violent resistance from drug dealers, who have burned and threatened doctors, gives plain evidence that “drug policy as it has been implemented in Colombia is a complete failure,” according to reports by Radio Santa Fe.

Diana Guzman, policy researcher at DeJusticia and contributing author of the CEDD’s report on Colombian drug policy, identifies Colombia’s main problem in tackling drug consumption as the insufficient budget for health care.

While investment in accessible and high-quality rehabilitation services is an urgent priority, the Colombian government has “not invested in sufficient resources to address the situation from a health standpoint,” she told Colombia Reports.